HomeMy WebLinkAboutPlumbing Permit #12-0444 � �� V
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED S � � ` / �
AODRESS ���LS e �,d�' lX�1Qi � � � �
OWNER CONTR.
PHONE NO. PERMIT NO. �"� �7` T�
0 FOOTING 0 PLUMBING RI ❑ EXIGRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMING C1 WATER HOOKUP ❑ FIREPLACE RI
❑ lNSULATION ❑ SEWER HOOKUP ❑ FIREPLI�CE FINAL
❑ FINAL � PLUMBING FINAL C7 G!}SLINE AIR TST
� SITE INSPECTION 0 MECH FINAL f] ,�
COMMENTS: .��-�
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❑ WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL Ff'�R REINSPECTION BEFORE COVER�NG
Inspector: � Owner/Contr.
CALL 44�-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL NEALTH & SAFETY!
WSN0T1
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� CITY OF PRIOR LAKE PLUMBING PERMIT
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3. YeUow Applicanl
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ADDItESS ZONiNG (ot�'ix use)
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LEGAL llE3CRIPTION (oBFice use only)
LOT BLOCK ADDITIQN FID
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(Address) � �a C (=
APPLIC /�
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(Address) 'rJ ,(,l,(,{, 1 I `'J�
(Ad s} (City} (Zip Code}
(Contact Persan) � {Phone} _ _ �I Z' 7 �{'I - O �i � 3
APPLICANT SIGNATURE G� DATE �t `ZLJ `�� Z
APPLICANT PLEASE COMPLETE BELOW
uantl T e of Fixture uanti T e of Fix#ure
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floar Drain Water Softener
Lavato Bativraam Sink Stand Pi ashin Machi.ne
Laun Tra 1 or 2 co arirnent sinlc Sewa e E'ector
Shower Stall Backflow Assembl
Si��� Bacicflow Assembl Test
B� S� Lawn S rinkler
Water Closet oilet Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of,job cost with a$49.50 minimum Residential, New One & TwaFamily $149.50
ResidentiaE, Additions & Alterations $44.50
The Minrtesota Statutes $ 326F;,lag . �� st $ 4•�� Building Permit #
"SURC.HARGE" has been ch�nged for ane
Y�►r eff'sctive PLUMBIl�iG PERMIT FEE $ �
.Juty � , 20io. eenti[ .�une 30. ZO! �. STATE SURCHA.R.GE $ + � �
Thc mirtiinuei surchargc for a"Csxed fce" p�rmit TOTAI, PERNIIT FEE $ �
is �, beginniug Juty i, 20]0
This Application Becomes Your Bnilding �ermit When Approved Paid ��" �� eipt No. r � f
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$aiidine Offlefal Date �� J b L V � I� •
24 Lour notice for all inspectiona (952) 447-9850, fax (952) 447-4243 _.
4b46 Dakota Street S.E., Prlor Lake, Mlnnesota 55372